Focus on Transparency: Slovakia

With the introduction of the changes brought by the EFPIA Disclosure Code to local Codes of member associations by the end of the year (see here), many European countries are about to face changes in the way they approach the allocation, collection and aggregation of sponsorship and grants to healthcare professionals (HCPs) and healthcare organisations (HCOs). However, several member countries have not waited for this new code and have already started disclosing payments (France, Netherlands…); Slovakia is one of them as, like in France, it is a legal obligation (Slovak Transparency Act) for pharmaceutical companies to disclose their interactions with HCPs.

Since healthcare expenditure in Slovakia had already risen to nine percent of the GDP by 2009, the Slovak Republic has adopted various measures in the fight against corruption and to enhance transparency: the Slovak “Sunshine Act” is one of these measures. Under the law, companies must annually submit by January 31st, a report to the Ministry of Health with the value of marketing expenses and non-monetary benefits provided directly or indirectly to HCPs. The Ministry then publishes these payments on its website. Transfers of value for ‘Research and Development’ are not to be disclosed, nor the payments made to HCOs.

Recently, Transparency International Slovakia “has launched a new portal called Transparent Doctors (Transparentní lekári – lekari.transparency.sk), which aggregates open data on collaboration and financial relations between doctors and pharmaceutical companies and allows search and comparison of this data” (www.transparency.sk). The portal discloses information on relationships between HCPs and companies between December 2011 and March 2013. One of the main reasons for this website is that “a significant number of doctors do not fulfil their legal obligation to inform about their income from pharmaceutical companies. Only 51 doctors have reported to be supported by companies to participate in expert events abroad. At the same time, companies themselves have reported more than 300 congresses, with more than 1000 participating Slovak doctor”.

The driving force of the Slovak Republic in the struggle against corruption and for increased transparency is a model in Europe for a global platform registering financial relationships between pharmaceutical companies and HCPs. However, the lack of clear processes for disclosure and of information to the public demonstrates the need for a robust plan in Europe for the implementation of data collection, aggregation and improved transparency. The Slovak Association of Research-Based Pharmaceutical Companies (SAFS) will integrate the EFPIA Disclosure Code in its own Code of Conduct by the end of this year and another layer of transparency (with HCOs, consulting…) will be added. Slovakia should therefore be looked at as an example of the implementation of disclosure regulations: other European countries should consider the difficulties faced by this country and the challenges it has had to overcome since the implementation of the “Sunshine Act”.